Objective : To assess intra- and interobserver reproducibility of Sanders Classification System of calcaneal fractures among experienced and less experienced observers. Methods : Forty-six CT scans of intra-articular calcaneal fractures were reviewed. Four observers, two with ten years of experience in foot and ankle surgery and two third-year residents in Orthopedics and Traumatology classified the fractures on two separate occasions three weeks apart from each other. The intra and inter-observer reliability was analyzed using the Kappa index. Results : There was good intraobserver reliability for the two experienced observers and one less experienced observer (Kappa values 0.640, 0.632 and 0.629, respectively). The interobserver reliability was fair between the experienced observers (Kappa = 0.289) and moderate among the less experienced observers (Kappa = 0.527). Conclusions : The Sanders Classification System showed good intraobserver reliability, but interobserver reproducibility below the ideal level, both among experienced and less experienced observers. Level of Evidence III, Diagnostic Studies.

Granuloma anular (GA) é uma dermatose benigna, caracterizada em geral por lesões papulosas em disposição anular. As formas clínicas englobam GA localizado, GA generalizado, GA perfurante e GA profundo. É de etiologia desconhecida, apesar de diversos fatores serem incriminados, inclusive doenças auto-imunes. Apresentamos o caso de paciente masculino de 45 anos, com lesões dermatológicas características de GA localizado, associadas a alterações sistêmicas, cuja investigação diagnóstica demonstrou tratar-se de hipertireoidismo por Doença de Graves. O paciente foi submetido a tratamento endócrino e dermatológico com controle do quadro clínico. A inusitada associação do GA localizado com hipertireoidismo, não encontrada na literatura médica, nos estimulou a publicar este caso.

Granuloma annulare (GA) is a begin dermatosis characterized, in general, for papular lesions with annular configuration. Its clinical forms comprehend localized GA, generalized GA, perforating GA and subcutaneous GA. With unknown etiology many factors have been responsible, including autoimmune diseases. We describe a case of a 45-year-old man, with characteristic dermatological injuries of localized GA, associated to systemic alterations, compatible with hyperthyroidism (Graves’ disease). The patient was submitted to an endocrine and dermatological treatment with control of the clinical state. The unusual association of localized GA with hyperthyroidism, not found in the medical literature, stimulated us to publish the case.

A rotura do manguito rotador é uma afecção freqüente com repercussão na vida diária do paciente causando incapacidade funcional e dor. Um número considerável de pacientes necessita de reparação tendínea. A tendência atual na cirurgia do ombro é a utilização de técnicas minimamente invasivas com menor morbidade operatória e reabilitação mais precoce. A partir dos anos 90 houve um grande desenvolvimento da artroscopia do ombro e na utilização de âncoras para fixação das suturas tendíneas. Essa evolução técnica tem permitido resultados da cirurgia artroscópica comparáveis aos da cirurgia aberta. Um dos possíveis problemas do uso de âncoras nas cirurgias artroscópicas do ombro é sua soltura da superfície óssea. O presente estudo tem o objetivo de comparar a resistência à tração das âncoras metálicas rosqueadas inseridas no osso cortical e no osso esponjoso.

Rotator cuff rupture is a common affection causing an impact on the daily lives of patients, resulting in functional disability and pain. A reasonable number of patients need tendinous repair. Current trends on shoulder surgery are the use of minimally invasive techniques with lower per-operative morbidity and earlier rehabilitation. From the 1990's on, shoulder arthroscopy was largely developed, as well as the use of anchors for tendinous sutures fixation. This technical evolution has allowed for arthroscopic surgery outcomes comparable to those in open surgeries. One of the potential problems for the use of anchors in shoulder arthroscopic surgeries is related to its loosening from bone surface. The present study has as an objective to compare the tensile strength of threaded metal anchors inserted on cortical and spongy bones.